Comparison Of Single-Shot Spinal Anaesthesia and Continuous Spinal Anaesthesia In Patients Undergoing Open Prostatectomy

Yıl 2018, Cilt: 6 Sayı: 2, 17 - 24, 04.02.2018

Demet Yediçocuklu Sergin

Öz

Abstract

Aim:In this study, in patients undergoing open prostatectomy, comparison of sin-gle shot spinal anesthesia (SSA) and continuous spinal anesthesia (CSA) methods in termsof hemodynamics, quality of anesthesia, and complications  was aimed.

Material and Methods:42 patients (ASA I-III) over 50 years of age were randomly divided into two groups. Patients in  group SSA (n=21) received  3.5 ml of hyperbaricbupivacaine 0.5%. Patients in group CSA (n=21) received1.5 ml hyperbaric bupivacaine 0.5% intrathecally. Sensorial blockade reached at thoracal 10 (T-10) and at Bromage Scale 3, the first with 15 minutes and the latter doses with 5 minutes intervals 0,5 mL, hyperbaric bupivacaine %0,5 was administered. Throughout the operation patient’s non-invasive arterial blood pressure, heart rate, decrease in blood pressure 25%, amount of blood loss, additional fluid needs, vasoactive medication needs, atropine needs, additional local anesthetics needs, were recorded. Blocade performing time, the time full motor blockade and sen-sorial blockade’s reached at T-10, two segments regression time, resolution of motor and sensorial blockade time wererecorded.

Results:In CSA Group performing of anesthesia time,full motor blockade achievement time needed and the timeneeded for sensorial blockade to reach T-10 was long, twosegment regression time, motor sensorial blockade time were short. In SSA group hypotension, additional fluid need andephedrine need were higher than CSA group.

Conclusion: In CSA Group by low dose local anaest-hetic, appropriate anesthesia level and better hemodynamicstability were achieved. When CSA performed properly tosuitable patients, it is a reliable and effective technique.

Anahtar Kelimeler

Bupivacaine, Hemodyna-mics, Spinal anesthesia, CSA

Açık Prostatektomi Ameliyatı Geçirecek Hastalarda Tek Doz Spinal Anestezi ve Sürekli Spinal Anestezi Tekniklerinin Karşılaştırılması

Öz

Öz

Amaç: Bu çalışmada açık prostatektomi ameliyatı geçirecek hastalarda, tek doz spinal anestezi (SSA) ve sürekli spinal anestezi (CSA) yöntemlerinin hemodinami, anestezi kalitesi ve komplikasyonlar yönünden karşılaştırılması amaçlandı.

Gereç ve yöntem: 50 yaşın üzerinde, 42 hasta (ASA 1-3), randomize olarak iki gruba ayrıldı. SSA’e (n=21,) 3,5 ml %0,5 hiperbarik bupivakain verildi.  CSA’e (n=21) 1,5ml %0,5 hiperbarik bupivakain intratekal verildi. Sensoriyal blok torakal-10’a ve Bromage Skalası’nda 3’e ulaşana kadar ilki 15 dakika ve sonrakiler takip eden 5 dakika araile 0,5 ml %0,5 hiperbarik bupivakain uygulandı. Ameliyat süresince hastaların non invaziv arter basınçları, kalp atım sayıları, kan basınçlarındaki %25 düşme, kan kaybı miktarları, ek sıvı ihtiyaçları, vazoaktif medikasyon  gereksinimleri, atropin gereksinimleri, ek lokal anestezik ihtiyaçları kaydedildi. Blok uygulama süresi, tam motor blok ve sensoriyal bloğun torakal-10’a ulaşma zamanı, 2 segment regresyon süresi, motor blok ve duyusal bloğun bitiş zamanı kaydedildi.

Bulgular: CSA grubunda anestezi tekniğini uygulama süresi, tam motor blok oluşma süresi ve sensoriyal bloğun torakal-10’a ulaşma süresi uzun;  iki segment regresyonsüresi, motor blok ve duyusal blok süresi kısa bulundu. SSA grubunda hipotansiyon, eksıvı ihtiyacı, efedrin gereksinimi  CSA grubundan daha fazla bulundu.

Sonuç: CSA grubunda düşük doz lokal anestezikle, uygun anestezi düzeyi ve daha iyi hemodinamik stabilite sağlandı. CSA uygun hastaya, doğru bir şekilde uygulandığında güvenilir ve etkin bir yöntemdir.

Anahtar Kelimeler

Bupivakain, Hemodinami, Spinal anestezi, CSA

Kaynakça

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